Tag: MAC

YARMOUTH, Maine - Some providers in Round 2 competitive bidding areas (CBAs) say they're running into trouble billing for complex rehab accessories. “Sometimes we get paid, sometimes we don't—it's very haphazard,” said Joe McKnight, vice president of business development for Anaheim, Calif.-based Aero Mobility.Because complex rehab is excluded from competitive bidding, providers in Round 2 CBAs must use a KY or KE modifier on claims for accessories like batteries, chair backs...

FARGO, N.D. - Noridian Administrative Services has reported overpayments on some power mobility devices in Round 2 competitive bidding areas. Noridian says the problem stems from a system issue that led to DME MACs paying a higher rate than allowed under the program. Claims that meet the following criteria have been overpaid: processed on or after July 1, 2013, billed with the KJ modifier and submitted under a certain code (for a list of the codes, go here). Noridian says it will adjust these claims...

NASHVILLE, Tenn. - CGS, the DME MAC for Jurisdiction C, posted changes to the local coverage determination (LCD) for oxygen on Sept. 13. Two big changes: exercise testing must be supervised by a physician or other qualified individual; and home sleep testing requirements are limited to standalone overnight pulse oximetry. The revised LCD goes into effect Oct. 1, 2012.